| Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
Lomotil (diphenoxylate/atropine) and Imodium (loperamide) are two antidiarrheal medications that are used to treat acute and chronic diarrhea. These medications work in similar ways to decrease the number and frequency of bowel movements. Lomotil and Imodium are designed to be taken for short-term diarrhea, which usually resolves within a few days after taking the medication.
In many cases, diarrhea, although an unpleasant experience, is often mild and goes away on its own. The primary treatment for diarrhea is replacing fluids and electrolytes in order to prevent dehydration. However, medications like Lomotil and Imodium can be useful for acute diarrhea as well as chronic diarrhea associated with irritable bowel syndrome (IBS).
Despite their similarities in uses, Lomotil and Imodium have some differences to be mindful of. For example, these drugs contain different ingredients and have certain limitations. We’ll explore their differences and similarities here.
What are the main differences between Lomotil and Imodium?
Lomotil is a brand-name drug that can only be obtained with a prescription. It contains a combination of diphenoxylate (an opioid) and atropine (an anticholinergic drug).
Diphenoxylate is the primary ingredient that binds to opioid receptors in the gut to slow intestinal motility. Atropine is added to discourage drug abuse since diphenoxylate is a controlled substance on its own.
Imodium, also stylized as Imodium A-D, is the brand name for loperamide. Unlike Lomotil, Imodium can be purchased over the counter (OTC). Therefore, it’s more widely available.
Loperamide is a synthetic opioid that binds to opioid receptors in the intestinal wall to slow gut movement. It also blocks a chemical called acetylcholine and leads to decreased fluid and electrolyte loss. Because Imodium has minimal absorption in the central nervous system (CNS), it produces less CNS side effects that are common with other opioids, including diphenoxylate.
|Main differences between Lomotil and Imodium|
|Brand/generic status||Brand and generic version available||Brand and generic version available|
|What is the generic name?||Diphenoxylate/Atropine||Loperamide|
|What form(s) does the drug come in?||Oral tablet|
|What is the standard dosage?||Acute diarrhea:|
2 tablets (2.5 mg diphenoxylate/0.025 mg atropine) four times daily until initial control of diarrhea has been achieved.
Reduce the initial dosage to a maintenance dose (usually 2 tablets daily) as directed by a doctor. Discontinue if symptoms do not improve within 10 days.
4 mg initially, and then 2 mg after each loose stool. Maximum daily dose: 16 mg
Use a maintenance dose of 4 to 8 mg per day. Discontinue if symptoms do not improve within 10 days.
|How long is the typical treatment?||Short-term diarrhea that resolves within 10 days. Long-term use may be needed for chronic diarrhea.||Short-term diarrhea that resolves within 10 days. Long-term use may be needed for chronic diarrhea.|
|Who typically uses the medication?||Adults and children 13 years of age and older.||Adults and children 2 years of age and older. Children under 6 years old should consult with a doctor before taking Imodium liquid.|
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Conditions treated by Lomotil and Imodium
Lomotil is FDA-approved as an adjunctive treatment for diarrhea. This means that Lomotil is recommended as additional therapy along with primary treatment methods such as preventing dehydration.
Like Lomotil, Imodium is FDA-approved to treat several types of diarrhea. Imodium can be used to treat Traveler’s diarrhea as well as diarrhea caused by medications like chemotherapy. Lomotil and Imodium can also treat chronic diarrhea caused by irritable bowel syndrome (IBS).
Diarrhea is typically defined as having loose stools three or more times in one day. Acute diarrhea is often mild and usually lasts no more than one or two days. Food poisoning is one of the most common causes of acute diarrhea.
Chronic diarrhea is more severe and can last for more than four weeks at a time. Symptoms of diarrhea can go away on their own or last for much longer, which may require treatment with medication.
Is Lomotil or Imodium more effective?
Lomotil and Imodium are the most commonly used antidiarrheal agents. They are both effective and work relatively quickly to relieve symptoms of diarrhea. The best drug for you will depend on your overall condition, which should be assessed by your healthcare provider.
That being said, Imodium may be the more effective medication. Although there are no clinical trials that directly compare Lomotil and Imodium, some studies suggest that Imodium is a preferred option for treating diarrhea. One double-blind, crossover study found that loperamide was superior to diphenoxylate for treating diarrhea even at a 2.5-fold lower dose.
Another crossover study compared loperamide, diphenoxylate, and codeine for treating chronic diarrhea. Before treatment, 95% of participants experienced urgency as their main symptom of diarrhea. The study found that loperamide and codeine were more effective than diphenoxylate for relief. Diphenoxylate was found to have the most side effects while loperamide was shown to have the least.
Coverage and cost comparison of Lomotil vs. Imodium
Most Medicare Part D and insurance plans do not cover brand-name Lomotil. However, many insurance plans cover the generic version of the drug. Medicare Part D plans should cover diphenoxylate/atropine depending on your coverage. The average retail cost of generic Lomotil is around $38. Check with your pharmacy to see if you can use a discount savings card. SingleCare Lomotil coupons can lower the cost so that you pay around $12.
Imodium is an OTC drug that might not be covered by Medicare and insurance plans. Some plans may cover the generic form with a prescription. It’s best to check your insurance plan’s formulary to make sure. The average cost of loperamide is around $26. With a SingleCare discount, you can get generic loperamide tablets for about $14. In order to take advantage of OTC savings, you’ll still have to get a prescription from your doctor.
|Typically covered by insurance?||No||No|
|Typically covered by Medicare?||No||No|
|Standard dosage||2.5 mg diphenoxylate/0.025 mg atropine, quantity of 30 tablets||2 mg, quantity of 30 tablets|
|Typical Medicare copay||$0–$150||$0–$99|
Common side effects of Lomotil vs. Imodium
Side effects of Lomotil include drowsiness, dizziness, and nausea. Compared to Imodium, Lomotil may have more CNS side effects including headache, restlessness, and confusion.
The most common side effect associated with Imodium is constipation. Other common side effects include dizziness, nausea, and abdominal or stomach cramps.
In higher doses, serious side effects of Lomotil and Imodium could include severe drowsiness, hallucinations, and lethargy. Serious side effects like slowed breathing (respiratory depression) can also occur with toxic doses.
This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.
Source: DailyMed (Lomotil), DailyMed (Imodium)
Drug interactions of Lomotil vs. Imodium
Lomotil can interact with drugs like monoamine oxidase inhibitors (MAOIs) and CNS depressants. Taking an MAOI, like selegiline or phenelzine, with Lomotil may increase the risk of hypertensive crisis, or dangerously high blood pressure. The risk of adverse effects may also be increased while taking CNS depressant drugs like barbiturates, benzodiazepines, and muscle relaxants.
Unlike Lomotil, Imodium is more heavily processed in the liver by enzymes such as the CYP3A4 enzyme and CYP2C8 enzyme. Drugs that inhibit, or block, these enzymes can increase the levels of Imodium in the blood. As a result, taking these drugs together can increase the risk of adverse side effects.
|Monoamine oxidase inhibitors (MAOIs)||Yes||No|
This is not a complete list of drug interactions. Please consult your doctor before taking these medications.
Warnings of Lomotil and Imodium
Lomotil should not be used in children younger than 6 years of age due to an increased risk of respiratory and CNS depression. Those with obstructive jaundice or a known hypersensitivity to diphenoxylate or atropine should also avoid using Lomotil.
Imodium has been reported to cause Torsades de Pointes, cardiac arrest, and death when taken in higher than recommended doses. It’s recommended to only take the minimum required dosage as instructed by your healthcare provider. Imodium should not be used in toddlers and infants less than 2 years of age due to the risk of respiratory and CNS depression.
Lomotil and Imodium should not be used to treat diarrhea caused by bacterial infections. These drugs should not be used to treat diarrhea that is caused by organisms such as Clostridium difficile and Salmonella.
Consult your doctor if you have any medical conditions before taking these medications. It’s recommended to take these medications with medical advice from your healthcare provider.
Frequently asked questions about Lomotil vs. Imodium
What is Lomotil?
Lomotil is a prescription drug used as adjunctive therapy for diarrhea. Lomotil is available in brand-name and generic versions. It can be taken for acute or chronic diarrhea in adults and children who are 13 years of age and older.
What is Imodium?
Imodium is an over-the-counter (OTC) drug that is FDA-approved to treat diarrhea. Imodium is typically used to treat Traveler’s diarrhea although it can also treat chronic diarrhea caused by IBS. Imodium can treat adults and children who are 2 years of age and older.
Are Lomotil and Imodium the same?
No. Lomotil and Imodium are not the same. Although they work in similar ways, Lomotil can only be obtained with a prescription. Imodium can be purchased over the counter.
Is Lomotil or Imodium better?
Lomotil and Imodium are both effective drugs to treat diarrhea. Some research has shown that there is no significant difference in effectiveness between the two. However, other studies have shown that Imodium is more effective and better tolerated. Consult your doctor for the best treatment option that’s right for you.
Can I use Lomotil or Imodium while pregnant?
Some doctors may allow the use of Lomotil or Imodium during pregnancy only if it is necessary. Otherwise, Lomotil and Imodium are not generally recommended during pregnancy due to the possibility of fetal harm. Talk to your doctor for antidiarrheal options while pregnant.
Can I use Lomotil or Imodium with alcohol?
It is not recommended to drink alcohol while using Lomotil or Imodium. Lomotil and Imodium may cause adverse effects such as drowsiness and dizziness. Drinking alcohol can increase these side effects.
Why is Lomotil banned?
Lomotil is not a banned drug. However, it is a Schedule V controlled substance as classified by the DEA. This means that there is a potential for misuse and abuse when using this drug. By itself, diphenoxylate, the main active ingredient of Lomotil, is a Schedule II substance with a high potential for abuse.
Can you take Lomotil long term?
Lomotil is not recommended to be used for more than 10 days for acute diarrhea. In some cases, Lomotil can be used for long-term use, especially for chronic diarrhea. Long-term use of Lomotil should be monitored by a doctor.
What happens if Imodium doesn’t stop diarrhea?
Imodium should relieve symptoms of mild diarrhea within 48 hours. If you experience any of the following, you should call your doctor immediately:
- Blood in the stool
- Fever or temperature above 101.3°F
- Severe abdominal pain
- Passing six or more loose stools per day
- Diarrhea that lasts longer than 48 hours
- Symptoms such as severe lightheadedness, confusion, chest pain, or malaise
What is the strongest drug for diarrhea? ›
Bismuth subsalicylate (i.e., Pepto-Bismol) has been proven to be effective in children with chronic diarrhea and for adults with microscopic colitis. Clinical experience suggests that opioids and opioid agonists are the most effective prescription medications for treatment of chronic diarrhea.What is better than Imodium for diarrhea? ›
Pepto-Bismol is an OTC medication used to treat diarrhea in people ages 12 and older. Unlike Imodium A-D, it's also used to relieve other symptoms, including heartburn, indigestion, and nausea.What is the best prescription medication for diarrhea? ›
|Best medications for diarrhea|
|Imodium AD (loperamide)||Over-the-counter antidiarrheal||Oral|
|Lomotil (diphenoxylate / atropine)||Rx Antidiarrheal||Oral|
|Xifaxan (rifaximin)||Rx Antibiotic/Antibacterial||Oral|
|Alinia (nitazoxanide)||Rx Antiprotozoals||Oral|
Diarrhea usually stops 2 days after treatment with this medicine. If your symptoms do not improve or if they get worse within 10 days of treatment, check with your doctor. This medicine may cause serious stomach or bowel problems (eg, toxic megacolon). This is more likely if you also have ulcerative colitis.What do hospitals use to stop diarrhea? ›
Diarrhea treatment depends on the underlying cause. For bacterial and parasitic infections, your doctor will prescribe anti-infective medicines, such as antibiotics. Preventing dehydration is the main focus of viral diarrhea treatment. This means replacing electrolytes and drinking plenty of fluids.Why is Lomotil banned? ›
Lomotil is not a banned drug. However, it is a Schedule V controlled substance as classified by the DEA. This means that there is a potential for misuse and abuse when using this drug. By itself, diphenoxylate, the main active ingredient of Lomotil, is a Schedule II substance with a high potential for abuse.What is the fastest working anti diarrhea medicine? ›
Look for over-the-counter products like Imodium or Pepto-Bismol, which have the ingredients loperamide and bismuth subsalicylate, respectively. The active ingredient in Imodium works swiftly because it slows the movement of fluid through the intestines. This can quickly restore normal bowel function.Why do I still have diarrhea after taking Imodium? ›
Imodium will usually help to slow down your acute diarrhea in the first hour, but if your diarrhea continues you may need to take additional doses in the same day. Take no more than the recommended maximum dose per day.What to do if Imodium doesn't work? ›
If you have constipation with Imodium, stop taking the drug. Constipation may last for a few days after you take Imodium, but it typically goes away on its own. And drinking plenty of water can help ease constipation. However, if you have constipation that doesn't improve after a few days, see your doctor.What stops diarrhea fast naturally? ›
Bland, starchy, low-fiber foods like those included in the BRAT diet (bananas, bananas, rice, applesauce, toast) are binding, which can bulk stool and help you get rid of diarrhea fast. You can also try probiotics, glutamine supplements, or home remedies like herbal teas and rice water.
What is the first line treatment for diarrhea? ›
The most important treatment for diarrhea is to drink fluids that contain water, salt, and sugar, such as oral rehydration solution (ORS). Sports drinks (eg, Gatorade) may be acceptable if you are not dehydrated and are otherwise healthy.What should I drink when I have diarrhea? ›
Water, Pedialyte, fruit juices, caffeine-free soda, and salty broths are some good choices. According to the Cleveland Clinic, salt helps slow down the fluid loss, and sugar will help your body absorb the salt.How long does it take for Lomotil to kick in? ›
Your symptoms are likely to improve within 48 hours of taking Lomotil. It means you should see changes in the consistency (firmer) and frequency (lesser) of your stools. If your symptoms do not improve even after taking Lomotil for 10-days (adults) and 48-hours (children), make sure to get in touch with your doctor.Is it OK to take Lomotil every day? ›
If you and your doctor determine that Lomotil is safe and effective for you, you may take it short term or long term, depending on the type of diarrhea you have. Tell your doctor if you're taking Lomotil and your diarrhea doesn't improve within 10 days. They may ask you to stop using Lomotil and try another treatment.What happens if Lomotil doesn't work? ›
Diarrhea usually stops 2 days after treatment with this medicine. If your symptoms do not improve or if they get worse within 10 days of treatment, check with your doctor. This medicine may cause serious stomach or bowel problems (eg, toxic megacolon). This is more likely if you also have ulcerative colitis.How do pharmacists stop diarrhea? ›
Try an over the counter treatment.
There are a number of over the counter treatments available for diarrhea relief, such as loperamide (Imodium™), attapulgite (Kaopectate®), and bismuth subsalicylate (Pepto-Bismol®).
Stick to a diet of clear liquids for a day or two until the diarrhea stops. Avoid sugary fruit juices, caffeine, carbonated drinks, dairy products, and food that's greasy, overly sweet, or high in fiber. There's one exception to avoiding dairy products: Yogurt with live, active cultures may help curb diarrhea.Should I go to the ER for watery diarrhea? ›
When to Visit the ER for Diarrhea. You should seek medical attention as soon as possible for diarrhea with these symptoms: Diarrhea lasting more than two days. Blood or pus in the stool.What can I take instead of Lomotil? ›
- Atropine / diphenoxylate.
- Imodium A-D.
Lomotil (diphenoxylate / atropine) is a controlled medication, because it contains diphenoxylate, which is an opioid medication. At smaller doses, it's used to treat diarrhea and does not cause pain-relieving effects like morphine at recommended doses.
Is Lomotil bad for your heart? ›
Health care professionals should be aware that higher than recommended loperamide doses can result in serious cardiac adverse events including QT interval prolongation, Torsades de Pointes or other ventricular arrhythmias, syncope, and cardiac arrest.Do bananas help with diarrhea? ›
Foods to eat when you have diarrhea
BRAT stands for “bananas, rice, apples, toast.” These foods are bland, so they won't aggravate the digestive system. They're also binding, so they help firm up stool.
Is it safe to take for a long time? If you've bought loperamide for short-term diarrhoea, do not take it for longer than 48 hours without talking to a doctor. Loperamide may be used for long-lasting diarrhoea and by people who have a colostomy (stoma) if their doctor prescribes it.How long is too long for diarrhea? ›
Diarrhea is a common problem. It may last 1 or 2 days and goes away on its own. If diarrhea lasts more than 2 days it may mean you have a more serious problem.How long can I take Imodium for chronic diarrhea? ›
If you will be taking this medicine for acute diarrhea, you should not use it for more than 2 days, unless directed by your doctor.Is it normal to not poop after taking IMODIUM? ›
IMODIUM® slows down the movement (contractions) in your intestine so that you pass firmer stools less often. But usually, the drug doesn't completely stop you from having bowel movements3. Constipation may occur. If so, stop taking IMODIUM® and consult your doctor if constipation is severe.What can I take instead of IMODIUM? ›
- Imodium A-D.
- Atropine / difenoxin.
- Bismuth subsalicylate.
It's best to treat it early. Although acute diarrhea usually resolves on its own within a few days, you can get relief faster with IMODIUM products. IMODIUM products contain an active ingredient called Loperamide which works to help restore your body's natural rhythm so you can start to feel like yourself again.What not to eat when you have diarrhea? ›
You should avoid certain kinds of foods when you have diarrhea, including fried foods and greasy foods. Avoid fruits and vegetables that can cause gas, such as broccoli, peppers, beans, peas, berries, prunes, chickpeas, green leafy vegetables, and corn. Avoid caffeine, alcohol, and carbonated drinks.What causes explosive diarrhea after eating? ›
Simply put, rapid defecation after you eat is caused when an irritant or biological process of some kind disrupts your normal process of digestion. These unsettling events could be caused by external factors like viruses or bacteria, or could be due to diseases and food allergies.
Does Coke stop diarrhea? ›
Nurses' drug alert: cola drinks not recommended for diarrhea.Why is toast better than bread for diarrhea? ›
Toast adds bulk to your stool, making it more likely you will have a normal bowel movement. It is the 'T' in the anti-diarrhoea diet BRAT, which comprises bananas, rice, applesauce, and toast. These plain foods supply energy and nutrition without upsetting the stomach because they are easier to break down.Is chicken noodle soup good for diarrhea? ›
Diarrhea usually is not serious and often disappears within a day or so. Mom's advice is still the best when it comes to home treatments for diarrhea: Eat chicken soup and saltines and follow the BRAT diet – bananas, rice, applesauce and toast.Can you eat peanut butter when you have diarrhea? ›
Avoid high-fiber foods, such as nuts, whole grains, legumes, fruits and vegetables.Does Lomotil stop you from pooping? ›
It helps to decrease the number and frequency of bowel movements. It works by slowing the movement of the intestines. Diphenoxylate is similar to opioid pain relievers, but it acts mainly to slow the gut.Can you alternate Lomotil and Imodium? ›
Step 3: Alternate taking two Lomotil tablets and two Imodium tablets or Imodium AD every six hours, as shown below in the chart. reduce the number of Imodium or Imodium AD you are taking.How long does Lomotil effect last? ›
Your diarrhoea symptoms will improve within 48 hours of treatment with this medicine. How long do the effects of this medicine last? Lomotil Tablet remains active in the body for about 4 to 6 hours.Is Lomotil hard on the liver? ›
Diphenoxylate (applies to Lomotil) liver/renal
Diphenoxylate should be used with extreme caution in patients with advanced hepatorenal disease and in all patients with abnormal liver function since hepatic coma may be precipitated. Diphenoxylate is contraindicated in patients with obstructive jaundice.
Lomotil (diphenoxylate atropine combination) has been in use as an antidiarrhoeal agent. Due to presence of opioid (diphenoxylate), there are chances of abuse.How often can you take Lomotil 2.5 mg? ›
Initial And Maximum Recommended Dosage In Patients 13 Years Of Age And Older. The initial adult dosage is 2 Lomotil tablets four times daily (maximum total daily dose of 20 mg per day of diphenoxylate hydrochloride). Most patients will require this dosage until initial control of diarrhea has been achieved.
What are the reviews for Lomotil? ›
Lomotil has an average rating of 7.9 out of 10 from a total of 44 reviews for the treatment of Diarrhea. 73% of reviewers reported a positive experience, while 16% reported a negative experience.Does Lomotil stop stomach pain? ›
Lomotil Tablet is a medication used to treat diarrhea. It manages symptoms of diarrhea such as stomach pain, cramping, and loose stools. Lomotil Tablet is taken with or without food at the dose and duration recommended by the doctor.What happens if Imodium doesn't work? ›
If you have constipation with Imodium, stop taking the drug. Constipation may last for a few days after you take Imodium, but it typically goes away on its own. And drinking plenty of water can help ease constipation. However, if you have constipation that doesn't improve after a few days, see your doctor.Why do I still have diarrhea after IMODIUM? ›
Imodium will usually help to slow down your acute diarrhea in the first hour, but if your diarrhea continues you may need to take additional doses in the same day. Take no more than the recommended maximum dose per day.Is there a downside to IMODIUM? ›
This medicine may cause heart rhythm problems (eg, torsades de pointes, ventricular arrhythmias). Check with your doctor right away if you or your child have chest pain or discomfort, fast, slow, or irregular heartbeat, fainting, or trouble breathing. Loperamide may increase your risk for stomach or bowel problems.Can you take IMODIUM indefinitely? ›
Is it safe to take for a long time? If you've bought loperamide for short-term diarrhoea, do not take it for longer than 48 hours without talking to a doctor. Loperamide may be used for long-lasting diarrhoea and by people who have a colostomy (stoma) if their doctor prescribes it.What is the fluid of choice in diarrhea? ›
Give oral rehydration solution (ORS) immediately to dehydrated patients who can sit up and drink. If ORS is not available, you should provide water, broth, and/or other fluids. You should not provide drinks with a high sugar content, such as juice, soft drinks, or sports drinks, because they could worsen diarrhea.